100 articles - From Friday Dec 20 2024 to Friday Dec 27 2024
Guidelines and related publications, position statements, white papers, technical reviews, consensus statements, etc…
| Gastroenterology |
|---|
AGA Clinical Practice Update on Management of Portal Vein Thrombosis in Patients With Cirrhosis: Expert Review. BEST PRACTICE ADVICE 11: Portal vein revascularization with transjugular intrahepatic portosystemic shunting may be considered for selected patients with cirrhosis and PVT who have additional indications for transjugular intrahepatic portosystemic shunting, such as those with refractory ascites or variceal bleeding. Portal vein revascularization with transjugular intrahepatic portosystemic shunting may also be considered for transplantation candidates if recanalization can facilitate the technical feasibility of transplantation. |
AGA Clinical Practice Update on Screening and Surveillance in Individuals at Increased Risk for Gastric Cancer in the United States: Expert Review. BEST PRACTICE ADVICE 15: To achieve health equity, a personalized approach should be taken to assess an individual's risk for GC to determine whether screening and surveillance should be pursued. In conjunction, modifiable risk factors for GC should be distinctly addressed, as most of these risk factors disproportionately impact people at high risk for GC and represent health care disparities. |
meta-analyses and systematic reviews
| Clin Gastroenterol Hepatol |
|---|
Incidence of hepatobiliary malignancies in primary sclerosing cholangitis: systematic review and meta-analysis. The incidence of CCA in PSC is substantial, whereas HCC and GBC are rare. PSC-IBD patients may be at higher risk for HCC. These data should be validated in large, prospective studies, and may guide the development of evidence-based surveillance strategies for hepatobiliary malignancies in PSC. |
| Gastrointest Endosc |
Efficacy and Safety of Anti-Reflux Mucosectomy versus Radiofrequency Ablation of the Lower Esophageal Sphincter for the Treatment of Gastroesophageal Reflux Disease: A Systematic Review and Meta-Analysis. Both Stretta and ARMS are effective endoscopic treatment modalities for GERD. Although their clinical efficacy appears to be similar, the increased risk of dysphagia, bleeding, and perforation after ARMS should not be underestimated. |
Efficacy and safety of fully covered self-expanding metal stents in the management of Post sphincterotomy bleeding: a Systematic Review and Meta-analysis. Pooled rates (95% CI) of stent migration were 10% (5%, 20%). In most studies, FCSEMS were used after failure of conventional endoscopic treatments except in two studies, where these were used in some patients for primary treatment, and in others, after failure of conventional endoscopic treatments CONCLUSIONS: Our meta-analysis demonstrates the pooled efficacy and safety of FCSEMS in the management of post-sphincterotomy bleeding especially as a rescue treatment in patients with persistent bleeding after conventional endoscopic treatments. |
| Hepatology |
RCT, clinical trials, retrospective studies, etc…
| Aliment Pharmacol Ther |
|---|
Integrated Analysis of Vonoprazan Safety for Symptomatic Gastro-Oesophageal Reflux Disease or Erosive Oesophagitis. Vonoprazan was well tolerated. Its safety profile from both clinical trial and post-marketing data were consistent and comparable to that of its PPI comparators with respect to treatment-emergent adverse events. |
| Am J Gastroenterol |
Delisting From Liver Transplant List for Improvement and Re-compensation Among Decompensated Patients at one-year. ALD and HBV are most frequent etiologies for delisting due to liver disease improvement. About 10% of delisted patients develop re-compensation, with HBV etiology most likely to recompensate. Models and biomarkers are needed to identify these candidates for optimal use of deceased donor livers. |
Post-Transjugular Intrahepatic Portosystemic Shunt Right Atrial Pressure and Left Atrial Volume Index Predict Heart Failure and Mortality: Dual Center Experience. Increases in right atrial pressure and left atrial volume index post-TIPS, but not CCM status, predict post-TIPS HF and death, respectively. Surveillance echocardiography may play a role in identifying those at highest risk of decompensation post-TIPS. Further prospective study of CCM and its markers in relation with TIPS outcomes is warranted. |
Risk of extrahepatic malignancies in patients with autoimmune hepatitis: a nationwide cohort study. In this nationwide, population-based cohort, AIH was not associated with an increased risk of overall extrahepatic malignancy compared with age- and sex-matched controls. However, AIH itself increased the risk of lymphoma or myeloma, independent of immunosuppressant use. |
| Clin Gastroenterol Hepatol |
| Gastroenterology |
Effect of an Endoscopy Screening on Upper Gastrointestinal Cancer Mortality: A Community-based Multicenter Cluster Randomized Clinical Trial. An invitation to endoscopic screening reduced upper gastrointestinal cancer mortality in high-risk areas. In non-high-risk areas, an invitation to endoscopic screening based on risk scores did not significantly decrease upper gastrointestinal cancer deaths, but longer follow-up time was required. |
Glepaglutide, a Long-acting Glucagon-like Peptide-2 Analog, Reduces Parenteral Support in Patients with Short Bowel Syndrome: a Phase 3, Randomized, Controlled Trial. Glepaglutide treatment in SBS-IF patients resulted in clinically relevant reductions in PS requirements and was well tolerated. |
Human enteric glia diversity in health and disease: new avenues for the treatment of Hirschsprung disease. Two major enteric glial classes were identified in the pediatric intestine, highlighting the significant postnatal contribution of Schwann-like enteric glia to glial heterogeneity. Crucially, these glial subtypes persist in aganglionic segments of HSCR patients, offering a new target for their treatment using 5-HT agonists. |
In Obesity, Esophagogastric Junction Fat Impairs Esophageal Barrier Function and Dilates Intercellular Spaces via HIF-2α. We have elucidated molecular mechanisms whereby visceral fat of obese patients can impair esophageal barrier integrity by secreting substances that generate ROS, which activate HIF-2α in esophageal epithelial cells. These mechanisms could render the esophagus of obese individuals vulnerable to damage by acid and other noxious agents. |
| Gastrointest Endosc |
| Gut |
Mutational signatures define immune and Wnt-associated subtypes of ampullary carcinoma. Immunogenicity and Wnt pathway associations, emphasised by the mutational signatures, defined patients with prospective sensitivity to either immunotherapy or Wnt pathway inhibitors. This emphasises a novel mutational signature-based AMPAC classification with prognostic potential, suggesting prospective implications for subgroup-specific management of patients with AMPAC. |
| Hepatology |
LRP4 mutations promote tumour progression and resistance to anti-PD-1 therapy in recurrent hepatocellular carcinoma. Our results identified novel LRP4 mutations important in recurrent HCC. Inactivating LRP4 mutations were associated with resistance to anti-PD-1 therapy and could be useful biomarkers for precision therapy in patients with recurrent HCC. |
Prevalence of metabolic dysfunction-associated steatotic liver disease and fibrosis defined by liver elastography in the United States using National Health and Nutrition examination survey 2017-march 2020 and august 2021-august 2023 data. In the U.S. population, MASLD and fibrosis prevalence are high along with obesity and diabetes. Our findings suggest that early detection of chronic liver disease and targeting lifestyle and other modifiable risk factors may slow disease progression toward advanced fibrosis and cirrhosis. |
Primary Biliary Cholangitis: personalizing second-line therapies. They also have shown biochemical improvements among patients with an inadequate response to ursodeoxycholic acid but may improve symptoms of pruritus. Herein, we review the patient features to consider when deciding whether a second-line agent is indicated and which agent to consider for a truly personalized approach to PBC patient care. |
Reprogramming macrophages to treat liver diseases. Here we review the potential targets to modulate macrophage behavior in liver diseases and nanoscale therapeutics that aim to target and treat macrophages. We will summarize current knowledge on the diverse macrophage programs activated in chronic liver inflammation, cirrhosis, and HCC that may be of therapeutic interest for precision medicine. |
Unmet needs in diagnosis and management of portopulmonary hypertension: How far have we reached? In addition to recent POPH practice guidelines, continued efforts can be suggested to improve our understanding of prognostic factors, investigate newer medical treatments, and improve outcomes of POPH. Herein, we identify specific "unmet needs" that focus on expanding and complementing current POPH practice guidelines. |
| J Hepatol |
AI model using CT-based imaging biomarkers to predict hepatocellular carcinoma in patients with chronic hepatitis B. This AI prediction model, integrating deep learning-based auto-segmentation of CT images, offers improved performance in predicting HCC risk among patients with CHB compared to previous models. Impact and implications The AI-driven HCC prediction model (PLAN-B-DF), employing an automated CT segmentation algorithm, demonstrates a significant improvement in predictive accuracy and risk stratification among patients with CHB. Using a gradient-boosting algorithm and CT metrics such as visceral fat volume and myosteatosis, PLAN-B-DF outperforms previous models based solely on clinical and demographic data. This model not only shows a higher c-index compared to previous models, but also effectively classifies CHB patients into different risk groups. This model uses machine learning to analyze the complex relationships among various risk factors contributing to HCC occurrence, thereby offering more personalized surveillance for CHB patients. |
Carvedilol vs. propranolol for the prevention of decompensation and mortality in patients with compensated and decompensated cirrhosis. Our data endorse the current recommendation favoring the use of carvedilol in the prevention of a first decompensation of cirrhosis and suggest extending the recommendation for its preferential use to patients with decompensated cirrhosis without recurrent or refractory ascites. Impact and implications This study addresses a gap in the comparative effectiveness of classical non-selective beta-blockers (e.g., propranolol and nadolol) versus carvedilol in managing cirrhosis in both compensated and decompensated stages. Our results support the preferential use of carvedilol in both settings due to its superior efficacy in reducing first and further decompensation. However, the retrospective nature of the study and inherent selection biases advise caution against broadly applying these findings to patients with decompensated cirrhosis who exhibit signs of circulatory dysfunction or recurrent/refractory ascites. |
Safety and efficacy of GLP-1/FGF21 dual agonist HEC88473 in MASLD and T2DM: a randomized, double-blind, placebo-controlled study. Herein, we report the clinical safety and proof of concept data for the GLP-1/FGF21 dual agonist HEC88473. A 5-week treatment with HEC88473 was generally safe and well tolerated, with multiple positive effects observed, including reduced liver fat, and improved glycemic control, insulin resistance and lipid metabolism, together indicating comprehensive improvement in metabolic syndrome. Clinical trial number Chinese Drug Trial Identifier ( CTR20211088; ClinicalTrials.govNCT05943886. |
Single-cell RNA seq-derived signatures define response patterns to atezolizumab + bevacizumab in advanced hepatocellular carcinoma. Our study unveils two distinct molecular subsets of clinical benefit to atezolizumab plus bevacizumab in advanced HCC ("Immune-competent" and "Angiogenesis-driven") as well as the main traits of primary resistance to this therapy, thus providing a molecular framework to stratify patients based on clinical outcome and guiding potential strategies to overcome resistance. |
Plenty of the editorials are available as full text through the publisher website using the provided link
| Aliment Pharmacol Ther |
|---|
| Clin Gastroenterol Hepatol |
| Gastroenterology |
| Gastrointest Endosc |
| J Hepatol |
Differences between hepatocellular carcinoma caused by alcohol and other aetiologies. Instead, prognosis is driven by liver function, general condition, and tumor burden. This underscores the crucial role of early diagnosis through periodic surveillance in patients with Alcohol-related liver disease or Metabolic dysfunction-Associated Steatotic Liver Disease with increased alcoholic intake -related cirrhosis. |
misc publications eg case reports, tools of the trade, images of the month, etc…
| Am J Gastroenterol |
|---|
| Endoscopy |
| Gastroenterology |
| Gut |
| Hepatology |
| J Hepatol |
Letters to the editors and authors’ replies
| Aliment Pharmacol Ther |
|---|
| Gastroenterology |
| Gastrointest Endosc |
| Gut |
| J Hepatol |